Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection
Background. The prognosis of patients with advanced oropharyngeal carcinoma (OPSCC) is generally poor. The aim of this study is to investigate the different therapeutic approaches and identify prognostic factors associated with a worse outcome for patients treated for T4a OPSCC, in order to improve...
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doaj-ba8f6629bf4c46108ef0002e6c38972a2020-11-24T22:38:41ZengHindawi LimitedBioMed Research International2314-61332314-61412014-01-01201410.1155/2014/390825390825Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV InfectionGeorgios Psychogios0Konstantinos Mantsopoulos1Abbas Agaimy2Kathrin Brunner3Elisabeth Mangold4Johannes Zenk5Heinrich Iro6Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Waldstraße 1, 91054 Erlangen, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Waldstraße 1, 91054 Erlangen, GermanyInstitute of Pathology, Friedrich Alexander University of Erlangen-Nuremberg, Krankenhausstraße 10, 91054 Erlangen, GermanyInstitute of Pathology, Friedrich Alexander University of Erlangen-Nuremberg, Krankenhausstraße 10, 91054 Erlangen, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Waldstraße 1, 91054 Erlangen, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Waldstraße 1, 91054 Erlangen, GermanyDepartment of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University of Erlangen-Nuremberg, Waldstraße 1, 91054 Erlangen, GermanyBackground. The prognosis of patients with advanced oropharyngeal carcinoma (OPSCC) is generally poor. The aim of this study is to investigate the different therapeutic approaches and identify prognostic factors associated with a worse outcome for patients treated for T4a OPSCC, in order to improve treatment selection for the individual. Methods. A retrospective study was conducted on 426 patients with T4a OPC treated between 1980 and 2010. Eleven prognostic factors including treatment modality, lymph node staging, and p16 status as a surrogate marker for human papillomavirus (HPV) infection were analyzed. Results. Univariate analysis showed a significant difference in DSS between N0 and N+ (57.1% versus 26.9%, P<0.001), primary surgical and primary nonsurgical treatment (52.7% versus 31.4%, P<0.001), and perinodal invasion (51.7% versus 19.9%, P=0.011). P16-negative patients tended towards a worse DSS than p16-positive patients (40.2% versus 64.6%, P=0.126) but responded better to primary surgery than to nonsurgical treatment (71.4% versus 34.0%, P=0.113). Multivariate analysis identified the N category as an independent prognostic factor for survival. Conclusion. The survival of p16-negative patients was worse than p16-positive patients, although they seem to respond better to primary surgery. The strongest independent prognostic factor for T4a carcinomas proved to be the presence of lymph node metastases.http://dx.doi.org/10.1155/2014/390825 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Georgios Psychogios Konstantinos Mantsopoulos Abbas Agaimy Kathrin Brunner Elisabeth Mangold Johannes Zenk Heinrich Iro |
spellingShingle |
Georgios Psychogios Konstantinos Mantsopoulos Abbas Agaimy Kathrin Brunner Elisabeth Mangold Johannes Zenk Heinrich Iro Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection BioMed Research International |
author_facet |
Georgios Psychogios Konstantinos Mantsopoulos Abbas Agaimy Kathrin Brunner Elisabeth Mangold Johannes Zenk Heinrich Iro |
author_sort |
Georgios Psychogios |
title |
Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection |
title_short |
Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection |
title_full |
Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection |
title_fullStr |
Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection |
title_full_unstemmed |
Outcome and Prognostic Factors in T4a Oropharyngeal Carcinoma, Including the Role of HPV Infection |
title_sort |
outcome and prognostic factors in t4a oropharyngeal carcinoma, including the role of hpv infection |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2014-01-01 |
description |
Background. The prognosis of patients with advanced oropharyngeal carcinoma (OPSCC) is generally poor. The aim of this study is to investigate the different therapeutic approaches and identify prognostic factors associated with a worse outcome for patients treated for T4a OPSCC, in order to improve treatment selection for the individual. Methods. A retrospective study was conducted on 426 patients with T4a OPC treated between 1980 and 2010. Eleven prognostic factors including treatment modality, lymph node staging, and p16 status as a surrogate marker for human papillomavirus (HPV) infection were analyzed. Results. Univariate analysis showed a significant difference in DSS between N0 and N+ (57.1% versus 26.9%, P<0.001), primary surgical and primary nonsurgical treatment (52.7% versus 31.4%, P<0.001), and perinodal invasion (51.7% versus 19.9%, P=0.011). P16-negative patients tended towards a worse DSS than p16-positive patients (40.2% versus 64.6%, P=0.126) but responded better to primary surgery than to nonsurgical treatment (71.4% versus 34.0%, P=0.113). Multivariate analysis identified the N category as an independent prognostic factor for survival. Conclusion. The survival of p16-negative patients was worse than p16-positive patients, although they seem to respond better to primary surgery. The strongest independent prognostic factor for T4a carcinomas proved to be the presence of lymph node metastases. |
url |
http://dx.doi.org/10.1155/2014/390825 |
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